Table 2.
Hazard ratios and corresponding 95% confidence intervals for non-Hodgkin lymphoma (N case = 1,189) and multiple myeloma (N case = 217) associated with an interquartile rangea increase in hazardous air pollutant exposure in the Nurses’ Health Study (NHS, follow-up 1986–2012, person-years = 1,700,707) and Nurses’ Health Study II (NHSII, follow-up 1989–2019, person-years = 2,820,772)
| Hazardous air pollutant | Outcome | HRs (95% CIs) from meta-analysisb | P-value for heterogeneityc | NHSd | NHSIId |
|---|---|---|---|---|---|
|
| |||||
| 1,3-Butadiene | NHL overall | 0.97 (0.91, 1.04) | 0.58 | 0.96 (0.87, 1.04) | 0.99 (0.90, 1.10) |
| DLBCL | 0.96 (0.80, 1.15) | 0.82 | 0.94 (0.73, 1.20) | 0.98 (0.75, 1.27) | |
| FL | 0.97 (0.91, 1.04) | 0.58 | 0.92 (0.74, 1.14) | 0.92 (0.71, 1.19) | |
| CLL/SLL | 1.01 (0.93, 1.09) | 0.80 | 0.99 (0.83, 1.17) | 1.01 (0.93, 1.11) | |
| MM | 1.04 (0.90, 1.20) | 0.25 | 0.96 (0.78, 1.17) | 1.14 (0.92, 1.40) | |
| Benzene | NHL overall | 0.97 (0.90, 1.04) | 0.21 | 0.93 (0.84, 1.03) | 1.02 (0.92, 1.13) |
| DLBCL | 0.90 (0.74, 1.10) | 0.32 | 0.81 (0.61, 1.08) | 1.00 (0.75, 1.31) | |
| FL | 0.97 (0.90, 1.04) | 0.21 | 0.86 (0.67, 1.10) | 0.87 (0.66, 1.15) | |
| CLL/SLL | 1.04 (0.94, 1.15) | 0.97 | 1.04 (0.88, 1.21) | 1.04 (0.91, 1.19) | |
| MM | 1.07 (0.92, 1.25) | 0.31 | 1.00 (0.81, 1.23) | 1.17 (0.93, 1.47) | |
| Cadmium | NHL overall | 1.01 (0.99, 1.03) | 0.24 | 1.00 (0.96, 1.03) | 1.02 (1.00, 1.05) |
| DLBCL | 1.04 (1.00, 1.08) | 0.08 | 0.84 (0.66, 1.07) | 1.05 (1.01, 1.09) | |
| FL | 1.01 (0.99, 1.03) | 0.24 | 0.98 (0.88, 1.09) | 0.73 (0.55, 0.96) | |
| CLL/SLL | 1.02 (0.99, 1.06) | 0.66 | 1.02 (0.99, 1.06) | 1.00 (0.90, 1.11) | |
| MM | 0.95 (0.83, 1.07) | 0.72 | 0.96 (0.83, 1.10) | 0.91 (0.69, 1.19) | |
| Ethylene oxide | NHL overall | 1.00 (0.97, 1.03) | 0.98 | 1.00 (0.97, 1.03) | 1.00 (0.92, 1.08) |
| DLBCL | 1.00 (0.89, 1.11) | 0.85 | 0.98 (0.81, 1.19) | 1.01 (0.88, 1.15) | |
| FL | 1.00 (0.97, 1.03) | 0.98 | 1.00 (0.96, 1.05) | 0.96 (0.77, 1.19) | |
| CLL/SLL | 0.98 (0.87, 1.11) | 0.94 | 0.99 (0.86, 1.12) | 0.97 (0.73, 1.30) | |
| MM | 0.98 (0.88, 1.09) | 0.31 | 1.00 (0.89, 1.11) | 0.84 (0.61, 1.16) | |
| Formaldehyde | NHL overall | 0.96 (0.89, 1.04) | 0.63 | 0.95 (0.86, 1.05) | 0.99 (0.86, 1.13) |
| DLBCL | 0.92 (0.75, 1.13) | 0.49 | 0.86 (0.65, 1.14) | 0.99 (0.74, 1.33) | |
| FL | 0.96 (0.89, 1.04) | 0.63 | 1.03 (0.81, 1.31) | 0.97 (0.74, 1.27) | |
| CLL/SLL | 1.06 (0.95, 1.18) | 0.73 | 1.07 (0.95, 1.20) | 1.02 (0.80, 1.30) | |
| MM | 1.00 (0.82, 1.21) | 0.55 | 0.95 (0.75, 1.22) | 1.09 (0.77, 1.54) | |
| Lead | NHL overall | 1.01 (0.98, 1.04) | 0.61 | 1.01 (0.98, 1.04) | 0.99 (0.92, 1.06) |
| DLBCL | 1.00 (0.95, 1.05) | 0.70 | 0.97 (0.82, 1.15) | 1.00 (0.95, 1.06) | |
| FL | 1.01 (0.98, 1.04) | 0.61 | 1.03 (0.97, 1.09) | 0.65 (0.47, 0.90) | |
| CLL/SLL | 1.02 (0.99, 1.06) | 0.17 | 1.02 (0.99, 1.06) | 0.81 (0.58, 1.13) | |
| MM | 0.99 (0.88, 1.11) | 0.75 | 1.00 (0.88, 1.13) | 0.95 (0.72, 1.26) | |
| Nickel | NHL overall | 1.01 (0.98, 1.03) | 0.43 | 0.99 (0.95, 1.03) | 1.01 (0.98, 1.04) |
| DLBCL | 1.02 (0.98, 1.05) | 0.39 | 0.94 (0.79, 1.13) | 1.02 (0.98, 1.06) | |
| FL | 1.01 (0.98, 1.03) | 0.43 | 1.01 (0.94, 1.07) | 0.96 (0.81, 1.12) | |
| CLL/SLL | 1.01 (0.98, 1.05) | 0.56 | 1.00 (0.93, 1.07) | 1.02 (0.98, 1.05) | |
| MM | 1.00 (0.95, 1.06) | 0.55 | 1.01 (0.95, 1.06) | 0.95 (0.80, 1.13) | |
| Trichloroethylene | NHL overall | 1.02 (0.99, 1.05) | 0.39 | 1.02 (0.99, 1.05) | 0.98 (0.88, 1.08) |
| DLBCL | 0.96 (0.82, 1.13) | 0.80 | 0.98 (0.80, 1.19) | 0.94 (0.71, 1.23) | |
| FL | 1.02 (0.99, 1.05) | 0.39 | 1.06 (1.03, 1.10) | 0.85 (0.64, 1.14) | |
| CLL/SLL | 1.02 (0.95, 1.09) | 0.79 | 1.02 (0.95, 1.09) | 0.99 (0.79, 1.23) | |
| MM | 0.96 (0.82, 1.11) | 0.79 | 0.94 (0.77, 1.15) | 0.98 (0.78, 1.23) | |
Effect estimates were associated with a 55 ng/m3 increase in 1,3-butadiene exposure; a 710 ng/m3 increase in benzene exposure; an 0.08 ng/m3 increase in exposure to cadmium; a 5.3 ng/m3 increase in ethylene oxide exposure; a 785 ng/m3 increase in formaldehyde exposure; a 2.06 ng/m3 increase in exposure to lead; a 1.1 ng/m3 increase in exposure to nickel; and, a 65 ng/m3 increase in trichloroethylene exposure.
Hazard ratios (HRs) and 95% confidence intervals (CIs) from a fixed-effects meta-analysis of cohort-specific associations.
From Cochran’s Q test to assess heterogeneity by cohort, from fixed-effects meta-analyses.
Models were stratified on age in months and follow-up cycle and further adjusted for race, BMI at age 18, current BMI, current smoking status, current AHEI diet score, current daily energy intake in tertiles, current alcohol consumption in tertiles, current physical activity in quintiles, marital status (ever married/ not married), current living arrangement, husband's highest educational level (1992 in NHS or 1999 in NHSII), mother’s occupation as a housewife when participant was 16 years old (only in NHS), father’s occupation as a professional/manager when participant was 16 years old (only in NHS), registered nursing degree in 1972 (only in NHS), current retirement status (only in NHS), household income in 2001 (only in NHSII), current region of residence, current neighborhood SES score, current neighborhood population density.
AHEI = Alternative Healthy Eating Index, BMI = body mass index, CLL/SLL = chronic lymphocytic leukemia/small lymphocytic lymphoma, DLBCL = diffuse large B-cell lymphoma, FL = follicular lymphoma, MET = metabolic equivalent of task, MM = multiple myeloma, NHL = non-Hodgkin lymphoma, SES = socioeconomic status